What are your preferred non-benzodiazepine therapies for the hyperactive/agitated phase of methamphetamine withdrawal, both in the hospital and in the office?  

In our outpatient substance use disorder practice, we tend to use lisdexamphetamine (Vyvanse) at fairly high doses off-label for patients with meth withdrawal. We establish a buddy system preferably with someone who lives with them, provide Suicide hotline phone number, describe reasons to transport...

From an inpatient perspective:  Dexmedetomidine [Precedex] IV if in the ICU or stepdown/transitional care unit that allows the infusion. It is well tolerated and, when effective, is a great tool to get the patient through an "acute" phase of his/her care. Ketamine IV [infusion] - there may ...